Early intervention in psychiatry: scotomas, representativeness, and the lens of clinical populations

Soc Psychiatry Psychiatr Epidemiol. 2019 Sep;54(9):1019-1021. doi: 10.1007/s00127-019-01686-x. Epub 2019 Mar 22.


Evidence supporting early intervention in mental health has gained prominence in recent years, with services for first episode psychosis having led the way. Despite this momentum, however, the extent to which rapidly accumulating data has been collected in samples resembling real-world clinical populations remains unclear. Kline et al. compare and contrast two groups experiencing a first episode of psychosis: research participants, and a clinical sample receiving early intervention services at the same health centre. They find key differences-including the underrepresentation of vulnerable groups and surprisingly little overlap between the two samples-that should prompt reflection about blind spots, filters between research and clinical care, and how to tie the generation of evidence to practice-based research.

Keywords: Early psychosis; Generalizability; Implementation; Representativeness; Schizophrenia.

Publication types

  • Editorial

MeSH terms

  • Early Medical Intervention / trends*
  • Humans
  • Psychiatry / methods
  • Psychiatry / trends*
  • Psychotic Disorders / psychology*
  • Psychotic Disorders / therapy
  • Research Design*
  • Research Subjects / psychology*
  • Scotoma